Case Presentation: Xanthogranulomatous Pyelonephritis (XGP) is an uncommon sequelae of chronic renal inflammation whose process may invade local structures.  We present a rare case of an invasive Xanthogranulomatous Pyelonephritis (XGP) extending into the thoracic cavity in a 48 year-old female presenting with chronic productive cough. This previously healthy patient presented with dyspnea, productive cough, and [...]

Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides are systemic autoimmune diseases affecting small blood vessels.  The clinical signs and symptoms of ANCA vasculitis are nonspecific and may include multisystem manifestations.  As a result, many conditions mimic ANCA-associated vasculitis, making the diagnosis challenging.  We report a case of ANCA-positive vasculitis presenting as rapidly progressive glomerulonephritis that was initially [...]

Case Presentation: A 30 year old Hispanic female with no past medical history presented with a one week history of progressive dyspnea and lower extremity edema. Her dyspnea was present at rest, and she also reported orthopnea and nocturnal cough. She denied any associated chest pain, nausea, or diaphoresis. Upon presentation, vital signs were stable [...]

Case Presentation: A 24-year-old African-American woman presented with nausea, flank pain, and hematuria recurring over several months. Review of symptoms and past medical history were negative. She was a current smoker. Family history was noncontributory. Physical exam was significant for bilateral flank pain. Laboratory testing, serology, and kidney biopsy led to the diagnosis of rapidly [...]

Case Presentation: A 59 year-old female with past medical history of Hashimoto’s thyrotoxicosis was admitted because of fatigue, myalgia, acute renal injury with hematuria and proteinuria, positive p-ANCA, positive stool guaiac test, and elevated inflammatory markers. She also had a head CT and MRI done for a new onset of left foot numbness and both [...]

Case Presentation: A 45-year-old woman presented to our hospital for evaluation of chronic kidney disease. Three years earlier, she had been diagnosed at an outside institution with Sjögren’s syndrome after developing sicca symptoms with positive anti-Ro/SSA, antinuclear antibody, and rheumatoid factor titers. Progressive renal insufficiency was noted soon after, but she was lost to follow-up [...]

Case Presentation: A 22-year-old male with no PMH or FH of autoimmune diseases and no substance use history presented with several days of worsening dyspnea, pleuritic chest pain, cough and hemoptysis. On evaluation, his vital signs were T 98.3oF, BP 103/64 mmHg, HR 86/min, RR 21/min, SpO2 93%. Physical exam was notable for auscultation of [...]